This insight fundamentally reshapes our understanding of perioperative safety. The operating room environment is not a passive backdrop but an active clinical factor that directly influences patient outcomes.

The article identifies four critical domains that determine SSI risk:

1. Environmental surfaces as microbial reservoirs

Studies show that only one‑third of high‑touch surfaces in operating rooms are adequately cleaned during terminal cleaning, and peripheral elements perform even worse. This means that OR surfaces continuously carry microbial load, and microorganisms present on these surfaces can easily aerosolize due to staff movement and re‑enter the sterile field.

The process forms a clear cause‑and‑effect chain: A contaminated surface → particle dispersion → increased airborne microbial load → elevated SSI risk.

2. Cleanliness must be measured

OR hygiene becomes reliable only when it is assessed with objective tools. Without fluorescent markers, ATP testing, and real‑time audits, cleaning systematically underperforms, and staff remain unaware of hidden deficiencies that sustain the infection chain. Without measurement, there is no feedback and without feedback, there is no improvement. Surfaces continue to function as microbial reservoirs.

3. Interaction between surface contamination and airflow

A significant proportion of airborne particles in the OR originate from surfaces that are continuously disturbed by staff movement. Door openings, equipment relocation, and personnel traffic alter airflow patterns and particle distribution, allowing contaminants from surfaces to reach the sterile field.

The logic is straightforward: A contaminated surface releases particles when disturbed → these particles enter the air → they contaminate the sterile field → SSI risk increases. Surface hygiene therefore directly influences the effectiveness of ventilation systems.

4. EVS–SPD: two separate domains, one infection chain

Environmental Services (EVS) is responsible for the environment, while Sterile Processing (SPD) manages sterile instruments. If either domain fails, the sterile field is compromised. A contaminated environment can easily contaminate sterile instruments, increasing SSI risk. OR safety functions only when both areas operate in a coordinated, mutually reinforcing manner.

High‑reliability OR hygiene requires a systems approach

OR hygiene is not a simple cleaning task — it is a patient safety intervention. A high‑reliability model includes standardized SOPs, unidirectional workflows, objective monitoring, audit‑based feedback and training, EVS–SPD collaboration, and integrated management of airflow and human factors. Together, these elements form a system capable of sustainably reducing SSI risk.

How does all this connect to Resysten technology?

Every major claim is directly linked to the Resysten technology — and this connection is professionally defensible and evidence‑based.

1. Surfaces as microbial reservoirs → Resysten reduces bioburden long‑term

The Resysten coating prevents microbial adhesion, reduces proliferation, and remains active between cleaning cycles. As a result, fewer microorganisms are present on surfaces, fewer particles become airborne, and SSI risk decreases.

2. Cleanliness must be measured → Resysten stabilizes measured outcomes

Resysten reduces fluctuations in surface bioburden, making ATP and fluorescent marker results more consistent. This supports objective EVS performance. Stable surface conditions lead to stable measurement outcomes — improving EVS quality and reducing SSI incidence.

3. Surface contamination and airflow → Resysten reduces particle release into the air

By lowering surface contamination, Resysten reduces the number of particles released into the air during movement. This supports the effectiveness of laminar and directed airflow systems. Cleaner surfaces mean less aerosolization, cleaner air, and lower SSI risk.

4. EVS–SPD collaboration

Resysten provides long‑term surface protection in ORs, prep areas, and SPD‑adjacent spaces. A cleaner environment ensures that sterile instruments enter a truly clean setting, reducing SSI risk.

Resysten as a system‑level technological component

Resysten does not replace cleaning, ventilation, or SPD — it strengthens the entire system by keeping surface bioburden consistently low. Stable surface hygiene results in stable EVS performance, stable ventilation efficiency, and a stable sterile field — ultimately leading to fewer SSIs.